Vision screening in Jamaican children

ABSTRACT

OBJECTIVE: To determine the prevalence of vision impairment in Jamaican pre-school children. METHODS: A national sample of Jamaican children at the end of the pre-school years was identified using the quarterly Jamaican Labour Force Survey. Each year, this survey identifies 500 pre-school children (1 percent of the national population) using a two-stage stratified random sampling process based on electoral divisions. Over two successive years, a 1 percent and a 0.5 percent sample of children were identified (n=750). A total of 302 children had their distance and near visual acuity assessed. Information on socio-economic status and the parental perception of children's vision was obtained by parental interview. RESULTS: 10.4 Percent of the children were identified as being in need of further ophthalmological referral using the American Academy Screening Guidelines. 4.1 percent of the children were diagnosed as having "low vision" according to the World Health Organization classification. 45.8 percent of the children were unable to identify letters and required lap-card use for evaluation of vision. No gender or socioeconomic differences were identified between those children requiring further ophthalmological assessment and those who did not (p<0.05). Parental perception of children's visual impairment was shown to be an unsatisfactory tool to assist in determining children at high risk for vision impairment. CONCLUSION: Based on the rates of children requiring further ophthalmological evaluation and the rates of low vision identified in this study, the abscence of identifiable risk factors and the inaccuracy of parental perception, all Jamaican pre-school children should be offered vision screening. The inability to identify letters demands that screening programmes must have facilities available for using lap-cards. (AU)